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Background: The design of periodontal curette handles may cause or aggravate arm pain in dental practitioners. The authors conducted a four-month randomized controlled trial to evaluate the effects of curette handle diameter and weight on arm pain among dental hygienists and dentists. Methods: One hundred ten dental hygienists and dentists who performed scaling, root planing or dental prophylaxis procedures participated in this study. The authors assessed right wrist/hand, elbow/forearm and shoulder pain levels weekly. They randomized participants to receive either a set of light (14 grams) periodontal curettes with a large diameter (11 millimeters) or a set of heavy (34 g) periodontal curettes with a narrow diameter (8 mm). The authors compared changes in mean pain scores across the study period between intervention groups by using general linear models and controlling for covariates. Results: The improvement in pain scores across the three body regions was greater for participants who used the lighter, wider-diameter curettes. In the final adjusted model, the differences were statistically significant only for the shoulder region (P = .02). Conclusions: The study results show that dental instrument design has an effect on upper-extremity pain in dental practitioners. Using a lighter instrument with a wider diameter may be an easy and cost-effective intervention to reduce or prevent upper-extremity pain associated with dental hygiene procedures. Clinical implications: To prevent or reduce arm pain, practitioners should consider using lightweight instruments with large diameters when performing scaling and root planing procedures.